Estabilidade em implantes dentários: análise da frequência de ressonância e torque de inserção / Stability in dental implants: analysis of resonance frequency and insertion torque

As pesquisas clínicas na área da implantodontia apresentam uma grande dificuldade em relação à avaliação da osseointegração e estabilidade dos implantes. Dessa forma, a análise de frequência de ressonância (AFR) têm se tornado uma das principais ferramentas utilizadas, já que oferece, de forma simples e não invasiva, a possibilidade de se monitorar a estabilidade durante todo o período desejado. Outra medida também bastante usada na prática clínica é o torque de inserção dos implantes. No entanto, essa medida é limitada ao trans-cirúrgico e nos fornece unicamente a estabilidade primária dos implantes, o que a torna mais indicada para avaliação da possibilidade de se submeter à carga imediata. Este estudo apresenta como objetivos avaliar, por meio de um estudo transversal, se os valores do coeficiente de estabilidade do implante (ISQ) são similares em diferentes alturas do componente protético e diretamente na plataforma, quando mensurados por meio da AFR e avaliar por meio de uma revisão sistemática e meta-análise a relação entre o torque de inserção e a AFR, investigando se estes dois instrumentos fornecem avaliações similares da estabilidade primária de em um mesmo implante. Para tal, foi realizado um estudo transversal em 31 implantes osseointegrados com plataforma de hexágono externo, com 4.1 mm de diâmetro e comprimento maior ou igual a 10mm e uma revisão sistemática com ensaios clínicos que reportassem valores de ISQ e torque de inserção. Assim, nossos estudos recomendam que explorar e desenvolver a AFR como método de avaliação da estabilidade implantar deve ser uma busca ainda necessária das pesquisas científicas para melhor compreensão do comportamento dos implantes dentários, nos seus diversos momentos e situações na cavidade oral, bem como determinar um bom nível de estabilidade que consequentemente determinaria uma maior longevidade e funcionalidade dos implantes dentários

Clinical research in the implantology presents a great difficulty regarding the evaluation of the osseointegration and stability of the implants. Thus, resonance frequency analysis (RFA) has become one of the main tools used, since it offers, in a simple and non-invasive way, the possibility of monitoring the stabiblity during the desired period. Another measure also widely used in clinical practice is the insertion torque of the implants. However, this measureis limited to the transsurgical and provides only the primary stability of the implants, which makes it more suitable for evaluation the possibility of undergoing immediate loading. This study aims to evaluate, through a cross-sectional study, whether implant stability coefficient (ISQ) values are similar at different heights...

Accuracy of resonance frequency analysis by third generation Osstell® / Precisión del análisis de frecuencia de resonancia mediante Osstell® de tercera generación

The Resonance Frequency Analysis by Osstell® is used in the assessment of primary and secondary implant stability. The aim of this study was to determine its accuracy as a method of testing, checking its repeatability and reproducibility. A pilot study was performed whereby implants were placed in a cow rib to compare several ISQ measurements with the same SmartPeg transducer (repeatability), or with different SmartPegs (reproducibility). Statistical analysis of the data showed a high correlation of the ISQ values obtained in both assays, which suggests that Osstell®analysis can provide high repeatability and reproducibility.

El análisis de frecuencia de resonancia (AFR) por Osstell® se utiliza en la evaluación de la estabilidad primaria y secundaria del implante. El objetivo del presente estudio fue establecer la precisión del AFR mediante Osstell©, como método de prueba empleado en la determinación de la estabilidad implantaria. Se realizó un estudio experimental in vitro, en el que se colocaron implantes en una costilla de vaca y compararon diferentes mediciones del coeficiente de estabilidad del implante (ISQ) obtenidas sobre estos implantes con un mismo transductor SmartPeg (repetibilidad) o con diferentes SmartPegs (reproductibilidad). El análisis estadístico de los datos mostró una elevada correlación de los ISQ obtenidos en ambos ensayos, lo cual sugiere una reproductibilidad y repetibilidad elevada del análisis mediante Osstell.

Influencia de la orientación del sensor Osstell ISQ en los valores del coeficiente de estabilidad de los implantes / Influence of Osstell ISQ sensor orientation on implant stability quotient

Objetivo: en ciertas situaciones clínicas, puede ser necesario cambiar la orientación del sensor Osstell ISQ(TM) pero se desconocen los efectos de dicha modificación. El objetivo de la investigación fue verificar si los valores del coeficiente de estabilidad del implante (ISQ) difieren según cuál sea la orientación del sensor. Materiales y métodos: utilizando Osstell ISQ (Osstell Integration Diagnosis AB, Gotemburgo, Suecia), se midió el ISQ de 102 implantes de superficie Osteotite (Biomet 3i, Palm Beach Gardens, FL., Estados Unidos), con dos orientaciones diferentes del sensor: paralelo al SmartPeg (Integration Diagnostics AB, Gotemburg, Suecia) (vertical) y perpendicular a él (horizontal). Los valores de ISQ registrados para cada orientación se compararon mediante prueba de Wilcoxon para muestras relacionadas. Resultados: los valores de IsQ verticales difirieron de los ISQ horizontales en el 62,7 por ciento de los casos. Las diferencias entre los grupos resultaron estadísticamente significativas (P<0,05). La media de ISQ vertical (76,29) fue mayor que la de ISQ horizontal (74,78). Conclusión: si la situación clínica amerita un cambio de orientación del sensor, se deberá tener en cuenta que la medida de ISQ vertical observada podría diferir significativamente del valor que se habría obtenido realizando la medición de manera convencional.

Uso de dispositivos clínicos diagnósticos no processo de extração e colocação imediata de implantes dentários na zona estética / The use of clinical diagnostic devices on the extraction and immediate dental implant placement in the esthetic zone

O presente trabalho relatou, por meio de caso clínico, a reabilitação com restauração imediata de uma paciente com comprometimento estético e funcional, com a instalação de quatro implantes cônicos com tratamento de superfície e provisionalização no mesmo tempo cirúrgico. O planejamento foi executado com tomografia computadorizada cone-beam com afastamento de tecidos moles, cirurgia realizada com exodontias sem abertura de retalho, implantes instalados e submetidos ao medidor de estabilidade por análise de frequência de ressonância, sendo a prótese confeccionada com o uso de componentes protéticos em modo plataforma switching. O resultado obtido demonstrou que estes dispositivos diagnósticos estão bem incorporados à prática clínica e contribuem para o controle longitudinal da restauração definitiva.

The aim of this paper is to report through a clinical case the immediate implant placement and restoration of a severely compromised esthetic situation, using four tapered dental implants. Treatment planning was performed using ST-CBCT, along with flapless procedures and then the implant stability verified with an appropriate device. Also, the final prosthesis received platform-switched components. The clinical outcomes demonstrated that the diagnostic devices are well-incorporated into clinical practice and contribute for the long-term follow-up of the definitive restoration.

Resonance frequency analysis.

Initial stability at the placement and development of osseointegration are two major issues for implant survival. Implant stability is a mechanical phenomenon which is related to the local bone quality and quantity, type of implant, and placement technique used. The application of a simple, clinically applicable, non-invasive test to assess implant stability and osseointegration is considered highly desirable. Resonance frequency analysis (RFA) is one of such techniques which is most frequently used now days. The aim of this paper was to review and analyze critically the current available literature in the field of RFA, and to also discuss based on scientific evidence, the prognostic value of RFA to detect implants at risk of failure. A search was made using the PubMed database to find all the literature published on "Resonance frequency analysis for implant stability" till date. Articles discussed in vivo or in vitro studies comparing RFA with other methods of implant stability measurement and articles discussing its reliability were thoroughly reviewed and discussed. A limited number of clinical reports were found. Various studies have demonstrated the feasibility and predictability of the technique. However, most of these articles are based on retrospective data or uncontrolled cases. Randomized, prospective, parallel-armed longitudinal human trials are based on short-term results and long-term follow up are still scarce in this field. Nonetheless, from available literature, it may be concluded that RFA technique evaluates implant stability as a function of stiffness of the implant bone interface and is influenced by factors such as bone type, exposed implant height above the alveolar crest. Resonance frequency analysis could serve as a non-invasive diagnostic tool for detecting the implant stability of dental implants during the healing stages and in subsequent routine follow up care after treatment. Future studies, preferably randomized, prospective longitudinal studies are certainly needed to establish threshold ranges for implant stability and for implants at risk for losing stability for different implant system.

A comparative study on the accuracy of the devices for measuring the implant stability

STATEMENT OF PROBLEM: How the ISQ values measured by Osstell(TM) and Osstell(TM) Mentor are related, and whether the ISQ values acquired from the two machines changes in accordance with changes in implant stability are not yet fully understood. PURPOSE: The aim of this study was to find out correlation between the ISQ values acquired from Osstell(TM) and Osstell(TM) Mentor, and to evaluate the clinical effectiveness and accuracy of two devices. MATERIAL AND METHODS: Sixty two implants were inserted into 47 patients, and their ISQ values were measured using Osstell(TM) and Osstell(TM) Mentor. In the first stage surgery, the ISQ values of forty four implants inserted into thirty five patients were measured. In the second stage surgery, the values of fifty implants inserted into thirty seven patients were measured. The values were analyzed to determine the difference between the mean ISQ values of Osstell(TM) and Osstell(TM) Mentor. In addition, the correlation between implants used in the first and second stage of surgery with regard to their types and areas of insertion were analyzed. The difference between the ISQ values of 32 implants in each patient during the first and second stage was analyzed. The statistical assessment was carried out using SPSS V. 12.0 for Win. (SPSS Inc., Chicago, USA). The Pearson correlation coefficient was used to examine the correlation between Osstell(TM) and Osstell(TM) Mentor in the first and second stages of surgery, whereas the difference between their ISQ values was evaluated using a paired t-test. RESULTS: In the first stage, the mean ISQ value for Osstell(TM) and Osstell(TM) Mentor was 70.84 and 75.09, respectively, showing a significant difference (P < .01). In the second stage, the mean ISQ value of Osstell(TM) and Osstell(TM) Mentor was 71.76 and 75.94, respectively, also showing a significant difference (P < .01). The difference between the ISQ values in patients in the first and the second stages was significant with both instruments. CONCLUSION: The significant difference in the values obtained using the Osstell(TM) and Osstell(TM) Mentor between the first and second stages of implant surgery indicates that these values can be a convenient and precise way for evaluating the implant stability in clinical practice.

A study of Smartpeg(TM)'s lifetime according to sterilization for implant stability / 대한치과보철학회지

PURPOSE: Resonance Frequency Analysis(RFA) technique can be used as an effective method in measuring the implant stability and documenting the clinical results. This technique also determines how stable the implant is before performing a prosthetic practice. Having become one the guidelines of the implant therapy whose final objective is the immediate loading, the Osstell(TM) mentor is giving a lot of information to the clinicians recently. In this communication, experiments were performed to investigate how reliable the measured ISQ values by Osstell(TM) mentor are, and to see if those are also stable even after sterilization. As five objectives: 1) How stable measured ISQ values after fixation Smartpeg(TM)s for 400 times. 2) How stable measured ISQ values after 'attach-detach'Smartpeg(TM)s for 400 times. 3) How stable measured ISQ values after clinical sterilization methods. 4) How stable measured ISQ values after repeatedly sterilization in autoclave for 10 times. 5) What is the critical temperature which is lost the magnetism of Smartpeg(TM). MATERIALS AND METHODS: Clinical sterilization methods(Autoclave sterilization, Dentistar sterilization, Ultra violet sterilization, Vacuum dry unit sterilization, Boiling water sterilization, combined H(2)O(2) and Alcohol sterilization). Smartpeg(TM)s. D3 Block bone(3x9x2cm). Osstem implant(phi 4.1-10mm). Osstell(TM) mentor. Individual experiment was used 8 number of Smartpeg(TM)s and they had measured to ISQ values of before experiment and after experiment. RESULTS: 1. The measured ISQ values did not change after fixation Smartpeg(TM)s for 400 times. 2. There was no significant changes in the measured ISQ values of 'attach-detach Smartpeg(TM)s' for 400 times. 3. The measured ISQ values did not change after the usual clinical sterilization methods. 4. The measured ISQ values did not change after sterilization in autoclave for 10 times. 5. It was impossible to exactly measure the critical temperature which is lost the magnetism of Smartpeg(TM)s. But, the results was resulted to lost its magnetism in higher temperature than 150 degrees C/10 minute. CONCLUSION: The measured ISQ values showed insignificant differences in case of no changes in the magnetism of the Smartpeg(TM)s. It seems that the Smartpeg(TM)s can be used repeatedly in every measurement if the original magnetisms of the Smartpeg(TM)s can be recognized. There seems to be no significant changes in the measured ISQ values of 'attach-detach Smartpeg(TM)s' only if the screw pitches were unimpaired. The clinical sterilization methods seems acceptable because the result was resulted to lost its magnetism in higher temperature than 150 degrees C/10minute.

The effect of the recipient site depth and diameter on the implant primary stability in pig's ribs